Kinder, gentler therapies are available for back pain

For back pain, new guidelines from the American College of Physicians recommend starting with treatments such as acupuncture, massage and yoga, and turning to drugs or surgery only when those more active therapies don’t work.

Consumer Reports lists nondrug therapies.

Yoga and tai chi

These exercises strengthen the muscles in your abdomen and back that are crucial to supporting your back. They also improve balance and flexibility, and help you become more aware of a healthy posture. Yoga and tai chi also encourage a quieting of the mind that allows you to focus on movements or postures, which can ease stress and provide mental distance from your pain.

Good to know: For back pain, consider classes described as gentle or relaxing, and avoid those characterized as more strenuous with words like “power” or “Ashtanga.”

Massage

This treatment relaxes tense muscles and increases blood flow to injured areas. It also triggers the release of endorphins, feel-good hormones that decrease stress and anxiety associated with pain.

Good to know: A massage shouldn’t make you wince, so make sure that you communicate when the pressure feels good or is too intense.

Spinal manipulation

This treatment, done by chiropractors and some other health care professionals, uses controlled forces to adjust the spine and allow it to move more easily. There are rare reports of serious complications.

Good to know: Some doctors of osteopathic medicine offer spinal manipulation as part of their treatment.

Physical therapy

Physical therapy focuses on improving your ability to do your daily activities and teaches you how to prevent future back problems. Treatments vary, but most combine strengthening and stretching with passive care such as massage and low-level laser therapy.

Good to know: Physical therapy should be challenging. Once something becomes easy, Consumer Reports notes, the therapist should add weight, repetitions or new exercises.

Acupuncture

In Eastern thought, it’s believed that inserting thin needles at specific points on the body helps correct imbalances in qi, the flow of energy. From a Western perspective, acupuncture is believed to affect soft tissue and nerves in ways that lessen pain.

Good to know: Therapy shouldn’t be painful, but you might feel a slight twitch.

Additional therapies

According to Consumer Reports, the American College of Physicians says that at least some evidence supports them:

■ Biofeedback. A therapist will first teach you several relaxation techniques, such as deep breathing and progressively tensing and relaxing muscles throughout your body. Then you’ll be connected via electrodes to computer monitors that track your heart and breathing rates, muscle tension and skin temperature. The idea is that by watching the monitors while practicing those techniques, you can learn to relax tight muscles in your back and decrease physical reactions to daily stress that can worsen pain.

■ Low-level laser therapy. Pointing a laser at the injured site causes blood vessels to dilate, which can increase blood flow to the area. The laser may also temporarily desensitize pain receptors. Ask which type of laser will be used in your treatment. Socalled Class lllb lasers, which are typically used to treat pain, are safer because they don’t heat the skin or underlying tissue.

To learn more, visit ConsumerReports.org.